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Healthstyles, July 2, 2015: Imprisonment for Miscarrying

Around the world, pregnant women are ending up in prison when they miscarry. In some cases, women are being mandated to have caesarean sections to try to ensure a viable fetus, even if it means that a woman’s risk of dying increases. This is occurring as laws are increasingly passed that afford fertilized eggs, embryos and fetuses “personhood” status with full legal protections, even if the life of the mother is in jeopardy. And this includes for women who wanted to carry their pregnancy to term, with no intention of having an abortion.

Tomorrow on Healthstyles, producer Diana Mason, PhD, RN, discusses this issue with Nancy Sharts-Hopko, PhD, RN, a professor of Villanova University and expert in women’s health. You can listen to the interview by clicking here:

Producer Liz Seegert opens the program with health news and talks with Diana Mason after the interview. So tune in at 1:00 on WBAI, 99.5 FM in New York City, or go to www.wbai.org for the live stream of the program.

Healthstyles is sponsored by the Center for Health, Media & Policy at Hunter College, City University of New York.

A Neighborhood Model for Caregiver Support

The second in a two-part look at family caregiving in New York City.

A 15-minute ride from midtown Manhattan on the Number 7 train takes you to the community of Sunnyside. This thriving western Queens neighborhood has long been home to generations of immigrants — from the Irish and Italian workers who settled here after the opening of the Queensboro Bridge in 1909, to the multicultural and vibrant Asian, South Asian and Latin American communities that call Sunnyside home today.

sunnysidecsA short walk from the 40th street station is Sunnyside Community Services. What began in 1974 as a tiny senior center in a church basement, is now the largest community-based social services agency in western Queens. It serves over 14,000 residents of all ages, including 10,000 seniors, on premises and through its home care network.

Approximately 60 percent of those coming into the Center are Latino, according to Executive Director Judith Zangwill. For every older adult and family caregiver, the goal is to provide another layer of support, information and a bridge to services.

“We pride ourselves on a whole continuum of senior services,” she said. “If the entry point is the Center for Active Older Adults, then as a senior’s needs change, which they will, they can move seamlessly from one service to the next.”

The Center offers geriatric mental health, a caregivers program, case management, home care, adult day services, friendly visiting for homebound seniors, and a pet pal program, which helps older adults care for and keep their pets. “It’s a rich continuum,” she said.

courtesy Sunnyside Community Services

photo courtesy of  Sunnyside Community Services

It is also a place where family caregivers can find respite. That is especially important for many Latino caregivers, who may be hesitant to seek help, although they struggle with caring for an older parent or spouse who is frail, chronically ill, or in declining health.

“With Hispanic family caregivers, caregiving is ingrained in the culture and in the family unit,” said Shyvonne Noboa, LMSW, Director of the Western Queens Caregiver Network (WQCN). WQCN services are coordinated through the Sunnyside Center, providing information, referrals, counseling, and other practical and emotional assistance to caregivers in multiple languages.

“As this demography is living longer, caregivers are dealing with more multiple chronic illnesses and with Alzheimer’s disease. They find themselves obligated to go outside of their culture and their community to seem support services.”

When Hispanic caregivers first come to the Sunnyside Center, the first step is to help them deal with their feelings about being a caregiver, because many don’t see themselves in that formal role. “Once they accept that, we can move on to discuss what services we can put in place for the person they’re caring for,” Noboa said. Her Ecuadorian heritage, upbringing and fluency in Spanish helps caregivers feel that their concerns are understood.

The Center has one of the only Spanish-speaking caregiver support groups in western Queens, which helps family members more easily discuss their challenges. The Center may help the care recipient receive meals through case management, refer them to adult day care, home care, or provide individual respite. “Relieving the burden is of primary essence,” Noboa said.

Common adult day services like yoga, bingo, discussion groups and creative writing are offered. Equally important, said Zangwill, are the services for frail elderly and those with Alzheimer’s or other cognitive impairments. It helps them to remain as active as possible for as long as possible. “We provide a very home-like environment, with a kitchen, living area, and even showers,” Zangwill said. “It helps caregivers overcome their reluctance to leave their loved one in what they still perceive to be an institutional setting.”

Educating caregivers, respecting beliefs

Part of the challenge is educating caregivers about respite care, Noboa said. ”We help them understand that these services actually help them to be a better caregiver.”

 Another key aspect of the education process is addressing a caregiver’s belief system. “Another ingrained cultural issue is spirituality,” she said. “For many members, we need to educate them about medications, Alzheimer’s disease, and we tell them that while their faith will support them, there are other ways to support your loved one too. Discussing spirituality in our support groups is a real positive for them.”

Often the adult child moves in with mom or dad, or they get a new place together. That adds to the ease of caregiving by eliminating travel, but it can also add to the stress. The constant caregiving role sometimes makes caregivers feel like they’re losing their own identity. “We remind them that they need to take time out and care for themselves or they won’t be of use to the person they’re caring for,” Noboa said.

Executive Director Judith Zangwill

Executive Director Judith Zangwill

Caregivers get help navigating the health system and learn what services will help keep their loved one home for as long as possible.

This is essential for those who must take time off from work, often unpaid, to manage the many complex caregiving needs like multiple doctor appointments. “A comprehensive, holistic program is so critical,” said Zangwill. “We do the best we can, providing caregivers with both emotional support and help navigating the systems, from beginning to end.”

Funding of course, is an ongoing challenge. While the New York City Department for Aging is a “great partner,” Noboa said there has been no new funding since the Older Americans Act was last reauthorized in 2011. “We need more money to support informal free care and training caregivers. Funding is critical for respite care and how to navigate the system.”

An overwhelming need

It’s difficult enough caring for an older loved one without language and cultural barriers, but among non-native populations, “the need is overwhelming and the supply doesn’t come close” said Zangwill. “Housing, elder abuse, medication management, so many issues are connected.” Many of these problems are magnified in the immigrant population, she said, including how to navigate the system, advocate for themselves and overcoming language barriers.

One benefit to accessing services through Sunnyside is that “once trust is established, caregivers can stay within the same organization,” Zangwill said. Whether it’s adult day care or home care, “once that trust is there, it’s a safe feeling and they can access the continuum of care.” Agencies which are embedded in the community like Sunnyside are the ones who best know the needs of that community and best able to find place-based services.

But an aging population in New York City means a greater need for services in the years to come. “We need more social workers in community settings,” said Noboa. “Clients keep coming in on a daily and weekly basis. It’s a challenge but we do it, with a lot of support from our partners in western Queens.” She’s optimistic that future city budgets will reflect an understanding of staffing and funding needs.

“This is a 21st century issue for women in the workforce,” she said. “The program works, it’s there to support and understand cultural differences. We need a lot more support — just spend a day in our shoes and you will see why.”

The Center serves as a “second home” for many caregivers. “They feel safe, nurtured…everybody is here to support them. Our caregivers feel it’s a place they can let their guard down,” said Noboa.

Caregivers who come to Sunnyside know they’re not in it alone, said Zangwill. “One of our primary goals with our older population is to keep them in their communities with dignity. Most people want to stay in their homes, and we help them be able to do that.”

Neighborhood organizations like this are a pivotal model in providing comprehensive, holistic support for family caregivers and older adults. To find a similar center, caregivers can search the Eldercare Locator or contact their local Area Agency on Aging.

 

 Liz Seegert is supported by a Journalists in Aging fellowship, a collaboration of New America Media and the Gerontological Society of America, sponsored by the Silver Century Foundation.

 This story originally aired on WBAI-FM, NYC. Listen here.

Family Caregiving: Survival in the City

The profile of the family caregiver in America is changing. A new study from the National Alliance for Caregiving and AARP finds that although the “typical” family caregiver is a 49-year-old woman who takes care of a relative, caregivers are becoming as diverse as the American population.

It’s often assumed that “the elderly” and “family caregivers” are homogenous groups, but it only takes a walk down any block in a major city like New York to realize how far that is from the truth. There are nearly one and a half million older adults in New York and the aging of the population will push that number closer to 1.8 million over the next 15 years.

By 2030, there will be more older New Yorkers than elementary school children for the first time in the city’s history. As more family members become caregivers, many find themselves squeezed by their ethnic ties and cultural expectations on the one hand, and modern struggles with work, the high cost of city living and their own needs on the other.

Caregivers also say that finding and accessing the resources that could help them is frustrating, time consuming and often impossible. Instead, caregiving becomes a tap dance within a fragmented system that is often pieced together month by month or even week by week.

Soli’s Story

“i think there’s a stigma about talking about the reality of it, said 53-year old Soli Davis. ”it’s a very emotional journey.”

Soli Davis, family caregiver

Soli Davis

Davis’ mother has Parkinson’s disease, spinal stenoisis, vascular dementia, diabetes, high cholesterol, and high blood pressure. So five years ago, she moved in to her mother’s apartment on the upper west side of Manhattan to care for her.

Her half-Japanese, half African-American heritage means a strong tradition of caring for older relatives. “In my family it’s not even an issue,” said Davis. Before becoming her mother’s caregiver, she helped to care for her father and her grandparents.

In my family, it’s not even an issue that Id take care of my mother” — Soli Davis

Like other caregivers, she gave up her own apartment, her business, and much of her independence. “I’ve had businesses. Businesses come and go. Your mother you only get once,” she stressed. “Besides, we have a great relationship. We always have, so even if her needs are a lot, she’s not particularly clingy. And despite all of her health issues, she’s still one of the wisest, most loving people I’ve ever met.”

Davis credits her Japanese heritage with providing a different perspective on caregiving than many of her peers have.”In Japan to be of service is a privilege and an honor. It’s not to be subservient or a servant,” she explained. “I think there is a big difference culturally in America. I don’t know that the job of a caretaker is really respected here. If I go back to Japan, yeah, I’m a good daughter, but it’s completely expected.”

However, like many family caregivers, she is frustrated with the processes of juggling multiple appointments, multiple providers, multiple agencies, cutting through red tape and waging seemingly endless battles to get her mother appropriate home and community support services.

“I’m lucky in that I happen to navigate systems well. But if you’re not someone who is progressive and proactive, what happens to that mother, or one without a son or daughter who is unwilling or unable to sacrifice?” Her biggest complaint is that no umbrella exists to help caregivers find or coordinate the “kitchen sink” of federal, state, city, and neighborhood services.

The nation, intensified

New York City is in many ways an more intense version of the nation as a whole, according to Carol Levine, Director of the United Hospital Fund’s Families and Health Care Project. The project focuses on developing partnerships between health care professionals and family caregivers.

Carol Levine, United Hospital Fund

Carol Levine, United Hospital Fund

“Everything that’s happening elsewhere is happening here, but in a more compressed environment, with many more moving pieces and more languages, cultures, groups and heritages,” she explained. At the same time, there are more women in the workforce, families are smaller than in previous generations and more families are living further apart. Caregiving, especially among those who feel the strong pull of cultural tradition, becomes that much more stressful.

“You could call it the perfect storm, or you could call it an opportunity for someone to step up and do the right thing. It’s kind of both,” Levine said. Various federal and state efforts are underway to enact legislation protecting family caregivers from employment discrimination, train them to properly care for loved ones upon hospital discharge and provide other support to make their roles less stressful.

Jasmine’s Story

Jasmine Pearlman does not fit the mold of a stereotypical middle-aged caregiver. She was only 21 when her mother was diagnosed with non-Hodgkins lymphoma. Over the past 11 years, she has helped her mother through bypass surgery, angioplasty and an amputation.

“A lot of people told me to tend to my own life, and not worry so much about my mom because I was so young,” she said. But despite her youth and inexperience, she said that her Caribbean heritage taught her that “the family unit comes first. Life doesn’t back up because we’re young.”

I love my grandmother and I love my mother; The experience taking care of other people, it really changes you. You have to meet the challenges as they come. It’s a juggling act, really. It’s a lot of work-life balance issues. But it’s definitely worthwhile. — Jasmine Pearlman

Three years ago, that strong grounding in family ties prompted her to move her newly-widowed grandmother up to the Bronx from Florida, to live with her. The experience was quite different and much more challenging, than with her mother.

Read more

Healthstyles: Sunnyside Community Center & Bring on the #thisoppresseswomen stickers

Tune in to CHMP’s Healthstyles Radio Thursday, June 25th, from 1:00 to 2:00 PM on WBAI, 99.5 FM in New York City and streamed online here.  Barbara Glickstein hosts this week’s segment of Healthstyles. Here’s the line-up:

There’s no doubt that caring for an aging parent, spouse or loved one is challenging, frustrating, and stressful, Last week co-producer Liz Seegert talked with caregivers about those issues. This week, she tells us about one place that provides a lively “second home” for caregivers. It’s a window on what caregiving services can be and a real eye opener for what’s to come.

She produced this series supported by a Journalists in Aging Fellowship, a collaboration of New America Media and the Gerontological Society of America, sponsored by the Silver Century Foundation.

photocredit: National Women's Liberation

photocredit: National
Women’s Liberation

We welcome back guest Virginia Reath, artist, RPA in GYN/Women’s Health, and feminist activist. We talk about the power of feminist public art campaigns historically and this new campaign by the National Women’s Liberation @4womenslib and Redstockings @redstockings who teamed up and are plastering vintage Redstockings stickers over sexist subway ads in NYC. Every conversation with Virginia Reach is thought-provoking and always feels too short.

Healthstyles in produced by the Center for Health, Media and Policy. To hear archives of previous programs search here.

Healthstyles: Health and Social Challenges our nation faces

Tune in to CHMP’s Healthstyles Radio Thursday, June 18th, from 1:00 to 2:00 PM on WBAI, 99.5 FM in New York City and streamed online here.  In this segment of Healthstyles you’ll hear this:

Co-Producer Liz Seegert takes an in-depth look at some of New York’s diverse family caregivers and learns that most face similar challenges. Ms. Seegert’s report is part of a journalist-in-aging fellowship from the gerontological society of america and new america media, sponsored by the silver century foundation.

Next time, Liz Seegert will report on one center that offers caregivers some respite by giving their loved one the next best thing to home.

Graduate Fellow Kristin Westphaln’s segment;  Tale from the Crib: How sex trafficking could appear appealing to an adolescent

Healthstyles presents a “pimped out” tale from the crib as Kristi Westphaln tackles the topic of sex trafficking with a teen-aged twist.  The discussion of how sex trafficking could appear appealing to adolescents is joined by Ohio based expert pediatric nurse practitioner, Dr. Gail Hornor. Join Westphaln and Hornor as they define domestic minor sex trafficking, highlight teen-specific risk factors, identify  the long term consequences of involvement in sex trafficking, and focus on resiliency factors that can help protect our teens.

Help us to turn off the trafficking light.

As adolescent recruitment into sex trafficking exists,

we must empower teens with tools to resist.

Protect with all senses: look, listen, and feel.

Adolescence can be rough- but hope and love are real.

Healthstyles in produced by the Center for Health, Media and Policy. To hear archives of previous programs search here.

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